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Factors influencing willingness and ability to pay for social health insurance in Nigeria

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  • Yewande Kofoworola Ogundeji
  • Babatunde Akomolafe
  • Kelechi Ohiri
  • Nuhu Natie Butawa

Abstract

Background: Many low and middle-income countries are increasingly cognisant of the need to offer financial protection to its citizens through pre-payment schemes in order to curb high out of pocket expenditure and catastrophic spending on healthcare. However, there is limited rigorous contextual evidence to make decisions regarding optimal design of such schemes. This study assesses the willingness-to-pay (WTP) for the recently introduced state contributory health insurance scheme (SHIS) in Nigeria. Methods: The study took place in 6 local government areas in Kaduna state, North-west Nigeria. Data were collected from a household survey using a three-stage cluster sampling approach, with each household having the same probability of being selected. Interviews were conducted with 4000 individuals in 1020 households. Contingent valuation was used to elicit the willing to pay (WTP) for the household using the bidding game technique. The relationship between socioeconomic status and WTP was also examined using logistic regression models. Findings: About 82% of the household heads were willing to pay insurance premiums for their households, which came to an average of 513 Naira (1.68 USD) per month per person. The average amount individuals were willing to pay was lower in rural areas (611 Naira) compared to urban areas (463 Naira). These results were influenced by household size, level of education, occupation and household income. In addition, only 65% of the households had the ability to pay the average premium. Conclusion: Socioeconomic factors influence individuals’ WTP for contributory health insurance schemes. It is important to create awareness about the benefits of the insurance scheme, especially in rural areas, and in both the formal and informal sectors in Nigeria. WTP information can inform the amount of insurance premiums. However, it is important to consider differences between the WTP and the cost of benefits package to be offered, as the premium amount may need to be subsidized with public financing.

Suggested Citation

  • Yewande Kofoworola Ogundeji & Babatunde Akomolafe & Kelechi Ohiri & Nuhu Natie Butawa, 2019. "Factors influencing willingness and ability to pay for social health insurance in Nigeria," PLOS ONE, Public Library of Science, vol. 14(8), pages 1-10, August.
    • Handle: RePEc:plo:pone00:0220558
    DOI: 10.1371/journal.pone.0220558
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    References listed on IDEAS

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    1. Dong, Hengjin & Kouyate, Bocar & Cairns, John & Sauerborn, Rainer, 2005. "Inequality in willingness-to-pay for community-based health insurance," Health Policy, Elsevier, vol. 72(2), pages 149-156, May.
    2. Dong, Hengjin & Kouyate, Bocar & Snow, Rachel & Mugisha, Frederick & Sauerborn, Rainer, 2003. "Gender's effect on willingness-to-pay for community-based insurance in Burkina Faso," Health Policy, Elsevier, vol. 64(2), pages 153-162, May.
    3. Mihajlo Jakovljevic & Elena Potapchik & Larisa Popovich & Debasis Barik & Thomas E. Getzen, 2017. "Evolving Health Expenditure Landscape of the BRICS Nations and Projections to 2025," Health Economics, John Wiley & Sons, Ltd., vol. 26(7), pages 844-852, July.
    4. Nemanja Rancic & Mihajlo (Michael) Jakovljevic, 2016. "Long Term Health Spending Alongside Population Aging in N-11 Emerging Nations," Eastern European Business and Economics Journal, Eastern European Business and Economics Studies Centre, vol. 2(1), pages 2-26.
    5. Sayem Ahmed & Mohammad Enamul Hoque & Abdur Razzaque Sarker & Marufa Sultana & Ziaul Islam & Rukhsana Gazi & Jahangir A M Khan, 2016. "Willingness-to-Pay for Community-Based Health Insurance among Informal Workers in Urban Bangladesh," PLOS ONE, Public Library of Science, vol. 11(2), pages 1-16, February.
    6. Hengjin Dong & Bocar Kouyate & John Cairns & Frederick Mugisha & Rainer Sauerborn, 2003. "Willingness‐to‐pay for community‐based insurance in Burkina Faso," Health Economics, John Wiley & Sons, Ltd., vol. 12(10), pages 849-862, October.
    7. Asfaw, Abay & Braun, Joachim von, 2004. "Can community health insurance schemes shield the poor against the downside health effects of economic reforms? The case of rural ethiopia," Health Policy, Elsevier, vol. 70(1), pages 97-108, October.
    8. Huber, Joyce H., 1993. "Ensuring access to health care with the introduction of user fees: A Kenyan example," Social Science & Medicine, Elsevier, vol. 36(4), pages 485-494, February.
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